Individual
BRIAN STAWARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A, LP, LMFT
Contact information
Practice address
2230 COMO AVE, SAINT PAUL, MN 55108-1720
(651) 635-0095
(651) 635-0454
Mailing address
1605 EUSTIS ST, SAINT PAUL, MN 55108-1219
(651) 646-6393
(651) 255-2380
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2908
MN
106H00000X
Marriage & Family Therapist
0136
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
748250700
—
MN
Enumeration date
07/27/2006
Last updated
04/20/2009
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